The Role of Social Determinants of Health in Hydroxyurea Adherence Among Persons with Sickle Cell Disease: A Systematic Review

Location

Jiann-Ping Hsu College of Public Health (JPHCOPH)

Session Format

Oral Presentation

Co-Presenters and Faculty Mentors or Advisors

Dr. Tilicia L. Mayo-Gamble, Faculty Advisor

Abstract

Medication adherence in sickle cell disease (SCD) is associated with important clinical outcomes and social determinants of health (SDoH). This systematic literature review synthesized the literature on SDoH addressed in studies to improve hydroxyurea adherence in persons with SCD. SDoH that were identified have not been described in previous literature. SDoH were based on the five categories defined in Healthy People 2020. Twelve studies were selected and assessed for this systematic literature review using online databases. Four out of five categories of SDoH were highlighted in studies addressing hydroxyurea adherence. SDoH were divided between barriers versus facilitators. We found that health and healthcare access (i.e., access to care, health literacy) was the SDoH most reported as a barrier to hydroxyurea adherence. Social and community context (e.g., peer support, community health worker, and patient navigator) was the most common facilitator to hydroxyurea adherence. Our analysis highlights a gap in the literature related to education as a SDoH and its relationship to hydroxyurea adherence among persons with SCD. Social determinants of health are a challenge for clinicians to address. Future research should explore development of multilevel interventions that address social determinants of health to improve hydroxyurea adherence in African Americans with SCD.

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Presentation (Open Access)

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The Role of Social Determinants of Health in Hydroxyurea Adherence Among Persons with Sickle Cell Disease: A Systematic Review

Jiann-Ping Hsu College of Public Health (JPHCOPH)

Medication adherence in sickle cell disease (SCD) is associated with important clinical outcomes and social determinants of health (SDoH). This systematic literature review synthesized the literature on SDoH addressed in studies to improve hydroxyurea adherence in persons with SCD. SDoH that were identified have not been described in previous literature. SDoH were based on the five categories defined in Healthy People 2020. Twelve studies were selected and assessed for this systematic literature review using online databases. Four out of five categories of SDoH were highlighted in studies addressing hydroxyurea adherence. SDoH were divided between barriers versus facilitators. We found that health and healthcare access (i.e., access to care, health literacy) was the SDoH most reported as a barrier to hydroxyurea adherence. Social and community context (e.g., peer support, community health worker, and patient navigator) was the most common facilitator to hydroxyurea adherence. Our analysis highlights a gap in the literature related to education as a SDoH and its relationship to hydroxyurea adherence among persons with SCD. Social determinants of health are a challenge for clinicians to address. Future research should explore development of multilevel interventions that address social determinants of health to improve hydroxyurea adherence in African Americans with SCD.